HBV genotype B is associated with better response to interferon therapy in HBeAg(+) chronic hepatitis than genotype C
HBV genotype B is associated with better response to interferon therapy in HBeAg(+) chronic hepatitis than genotype C
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DOI：
10.1053/jhep.2002.37139
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发表时间：
2002-12-01
期刊：
影响因子：
13.5
通讯作者：
Lok, ASF
中科院分区：
文献类型：
--
作者：
Wai, CT;Chu, CJ;Lok, ASF
B型肝炎病毒（HBV）基因型和前C/核心启动子突变与自发性和干扰素α（IFN-α）相关的B e抗原（HBeAg）血清转换有关。我们对先前报道的随机对照试验进行了回顾性分析，以确定HBV基因型和前C/核心启动子突变对HBeAg阳性慢性肝炎患者IFN-α应答的影响。分析了原始试验中109例（95%）患者的临床数据和储存的血清。73名患者接受IFN-α治疗，34名患者未接受治疗（对照组）。几乎所有患者均为HBV基因型B（38%）和C（60%）。HBV基因型B和C的IFN-α治疗患者中分别有39%和17%（P = 0.03）和10%和8%（P = 0.88）获得抗病毒应答。多因素分析表明HBV基因型B、治疗前丙氨酸氨基转移酶（ALT）水平升高和治疗前HBV-DNA水平降低是与抗病毒应答相关的独立因素，但IFN-α治疗不是独立因素。在治疗前ALT水平升高的66例患者中，IFN-α治疗的HBV基因型B和C患者分别有57%和21%（P = 0.019）和25%和8%（P = 0.45）的未治疗对照组获得抗病毒应答。多因素分析显示，基因型B和治疗前低HBV-DNA水平是抗病毒应答的独立预测因素。总之，我们的数据显示HBV基因型B与IFN诱导的HBeAg清除率高于基因型C相关。慢性B型肝炎抗病毒治疗临床试验应考虑HBV基因型分层。
Hepatitis B virus (HBV) genotype and precore/core promoter mutations have been implicated in spontaneous and interferon alfa (IFN-alpha)-related hepatitis B e antigen (HBeAg) seroconversion. We performed a retrospective analysis of a previously reported randomized controlled trial to determine the effects of HBV genotype and precore/core promoter mutations on IFN-a response in patients with HBeAg-positive chronic hepatitis. Clinical data and stored sera from 109 (95%) patients in the original trial were analyzed. Seventy-three patients received IFN-alpha and 34 received no treatment (controls). Almost all patients had HBV genotypes B (38%) and C (60%). Antiviral response was achieved in 39% and 17% of IFN-alpha-treated patients (P = .03) and in 10% and 8% of untreated controls (P = .88) with HBV genotype B and C, respectively. Multivariate analysis identified HBV genotype B, elevated pretreatment alanine aminotransferase (ALT) levels, and low pretreatment HBV-DNA levels but not IFN-a treatment as independent factors associated with antiviral response. Among the 66 patients with elevated pretreatment ALT level, antiviral response was achieved in 57% and 21% of IFN-alpha-treated patients (P = .019), and in 25% and 8% of untreated controls (P = .45) with HBV genotype B and C, respectively. Multivariate analysis showed that genotype B and low pretreatment HBV-DNA levels were independent predictors of antiviral response. In conclusion, our data showed that HBV genotype B was associated with a higher rate of IFN-induced HBeAg clearance compared with genotype C. Stratification for HBV genotypes should be considered in future clinical trials of antiviral therapy of chronic hepatitis B.